From the Research
For heavy bleeding, the most effective dosing of tranexamic acid is 1 gram intravenously over 10 minutes, followed by another 1 gram if bleeding continues after 30 minutes or restarts within 24 hours, as supported by the most recent and highest quality study 1.
Key Considerations
- The dosing of tranexamic acid may vary depending on the clinical context, such as trauma, postpartum hemorrhage, or surgical bleeding.
- Early administration of tranexamic acid is crucial for efficacy, particularly in trauma and postpartum hemorrhage 1.
- The medication works by inhibiting plasminogen activation, which prevents the breakdown of blood clots and helps control bleeding.
- Side effects may include nausea, vomiting, diarrhea, and rarely, thromboembolic events.
- Dose adjustments are necessary for patients with kidney impairment.
Clinical Contexts
- For acute trauma or postpartum hemorrhage, the standard dose is 1 gram intravenously over 10 minutes, followed by another 1 gram if bleeding continues after 30 minutes or restarts within 24 hours.
- For surgical bleeding, 10-15 mg/kg intravenously before surgery and potentially repeated during or after surgery may be used.
- For heavy menstrual bleeding, tranexamic acid can be dosed at 1,000-1,300 mg orally three times daily for 3-5 days during menstruation, starting when bleeding begins.
Important Notes
- Tranexamic acid is contraindicated in patients with active thromboembolic disease, subarachnoid hemorrhage, or hypersensitivity to tranexamic acid.
- The use of tranexamic acid should be individualized, taking into account the patient's specific clinical context and risk factors for bleeding and thrombosis 1, 2.